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Topic: Billing Address & Hipaa 5010 (Read 6296 times)

I heard there is a new requirement for Ansi 5010 that we have to use a physical address for the billing address? Some of our providers use P.O. Boxes for mailing and billing (Box 33). Anybody finds this to be a problem?

Many of our providers use a PO box, too. The insurance companies just need to have the physical address on file, and we have not had many problems requesting all correspondence to to the PO box. There is always the insurance company (or two) who we have to tell several times to use the PO box, but they eventually all get it.

I haven't heard that but I can't imagine how they are going to do that. Many providers use PO Boxes or lock boxes to prevent office theft. Some use it just for administrative purposes, to keep payments separate from all other mail. But many use them for a variety of reasons.

In version 5010 you can no longer use a P.O. Box as the primary billing address. If a practice uses a P.O. Box for payments, correspondence, etc. it will need to be reported in the "Pay-To" provider field. (Not sure which loop/segment that's in for the 5010 format but your clearinghouse/software vendor should know.)

Speaking of 5010 format changes, make sure your software vendors/clearinghouses test early - there are some issues that are starting to get reported from early testing such as zip + 4 requirements in address fields, reporting dependents as subscribers, making sure NPI numbers are consistently enrolled, etc.

I don't have the links at my fingertips now but there is a bunch of info on the CMS/AMA and other websites that have more details on the testing that has been done to date and what to watch for regarding the 5010 format.

No more PO boxes or lock boxes. Providers who want to have payments sent to a different address will use the pay to address field's.

Also.. in 5010, billing provider MUST be a health care service/provider, can NO longer be a billing service or clearinghouse.

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I haven't heard that but I can't imagine how they are going to do that. Many providers use PO Boxes or lock boxes to prevent office theft.

this isn't an issue because as a covered entities, the physical address will not be presented to patient's, that really hasn't been an issue since HIPAA. Your bills you send patient's will still only contain PO boxes if you wish.

Any of you ladies using Lytec and Office Ally as clearing house? They use print image to pull claims and I'm not sure how to transmit the 'Pay To' field. I tried asking them but they keep putting me off Probably need an alternative option to pull Ansi 5010 format?

We use Lytec & Office Ally. And yes they are using print image. I will also see what I can find out and post it. I know they have been testing/preparing for 5010 but I hadn't addressed the pay to field yet. I will keep you posted!

I'm thinking they can make some changes like pulling info in box 32 for billing address and use box 33 for pay to address. I talked to a guy there once who is very knowledgeable in the 5010 process so will see if I can find him again because the customer service reps don't know squat. Will post here if I find out anything. Thanks Michele!

I've talked to Office Ally and apparently they are having issues with converting image format to Ansi 5010 and it looks like we will have to pull files electronically in 4010 or 5010 for processing. Then I think I need to get Revenue Mgmt Direct to work but not many resellers support it. They only support RMD Advanced to RelayHealth. Michele - is this correct and how are you handling this? thanks for your help

I've talked to Office Ally and apparently they are having issues with converting image format to Ansi 5010 and it looks like we will have to pull files electronically in 4010 or 5010 for processing. Then I think I need to get Revenue Mgmt Direct to work but not many resellers support it. They only support RMD Advanced to RelayHealth. Michele - is this correct and how are you handling this? thanks for your help

Version 5010 is the electronic format version that is replacing the 4010 version. The format change is necessary for the October 2013 deadline for ICD-10. Provider's, health plan's and clearinghouse's should be IN the testing phase now. Check with your software vendor to make sure they have adapted the necessary upgrades to accommodate the new 5010 Version.